CMS Price Transparency Data

X-ray, shoulder

Facility: Sanford Medical Center Bismarck

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $151
Cash Discount Price: $172
vs. Medicare Baseline: 1.70x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Sanford Medical Center Bismarck is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $172. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.70x the Medicare baseline. Located in 300 N 7Th St, Bismarck, ND.

Cash / Self-Pay

$172

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $172 (193%)

Insurance Median: $151 (170%)

Cash: $172 (193% of Medicare)

Ins. Median: $151 (170% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Sanford Health Plan	$35	39%
Sanford Health Plan Align	$84	94%
Ucare	$90 - $155	101%
Aetna	$91 - $182	102%
Blue Cross Blue Shield	$91	102%
Health Partners	$91 - $99	102%
Medicare (plans)	$91	102%
UnitedHealthcare	$91 - $178	102%
Primewest	$92	103%
Security Health Plan	$118	133%
Medica	$146 - $157	164%
Cigna	$194	218%
First Choice Health Network	$194	218%
Healthez	$194	218%
Multiplan	$194	218%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $172.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73030.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sanford Medical Center Bismarck is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73030.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.